| NPI | 1154541092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 300717) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F300717-1) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2021-12-13 |