| NPI | 1093976664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F306046) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN171017) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R212315) | |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2022-08-19 |