| NPI | 1194266163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 308448) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 308448) |
| 163W00000X Registered Nurse (Licence: NY 526598) | |
| Enumeration Date | 2017-03-10 |
| Last Update Date | 2021-03-05 |