| NPI | 1053554188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 307974) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 551661-1) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F307974-1) | |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2021-01-26 |