| NPI | 1104290915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F307302) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP015710) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: PA SP015710) | |
| 363LG0600X Nurse Practitioner Gerontology (Licence: PA SP015710) | |
| 163W00000X Registered Nurse (Licence: PA RN578441) | |
| 163W00000X Registered Nurse (Licence: NY 362456) | |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2023-08-31 |