| NPI | 1134646755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F308526) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: NY F308526) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 27196) | |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2025-08-28 |