| NPI | 1992313811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 346157) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 346157) |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2023-07-03 |