| NPI | 1992374771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 347897) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 755941) |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2021-07-09 |