| NPI | 1083154520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 308655) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR16647200) |
| 363L00000X Nurse Practitioner (Licence: NY 308655) | |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2023-06-07 |