| NPI | 1174881015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY 306039) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SD CP000766) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: PA SP021425) | |
| Enumeration Date | 2012-04-29 |
| Last Update Date | 2024-04-11 |