| NPI | 1023452992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 22064) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 22064) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F302704-1) | |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2022-01-27 |