| NPI | 1114361987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F306307-1) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F440040-1) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2022-04-11 |