| NPI | 1154634723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 305368) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 1503092) |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2021-10-15 |