| NPI | 1124579180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F307641-1) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 307641) |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2018-09-12 |