| NPI | 1194436998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY AG12220012) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 531712-01) |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2022-12-12 |