| NPI | 1154314920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 303794) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 303794) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2021-05-31 |