| NPI | 1003466780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY f309236-01) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 309236-01) |
| Enumeration Date | 2019-09-16 |
| Last Update Date | 2021-03-30 |