| NPI | 1194313841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 310140) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NH 035030-21) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NH 035030-23) | |
| Enumeration Date | 2021-01-07 |
| Last Update Date | 2024-09-26 |