| NPI | 1164848636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NM CNP-02937) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM RN-84068) |
| 163W00000X Registered Nurse (Licence: NY 673201) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 307181) | |
| Enumeration Date | 2014-03-08 |
| Last Update Date | 2019-01-25 |