| NPI | 1003632464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 301089) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 301089-01) |
| Enumeration Date | 2024-12-02 |
| Last Update Date | 2024-12-02 |