| NPI | 1205418753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 348196) |
| Additional Taxonomies | 163WC1600X Registered Nurse Continuing Education/Staff Development (Licence: NY 658951) |
| 363LF0000X Nurse Practitioner Family (Licence: NY 658951) | |
| Enumeration Date | 2021-04-24 |
| Last Update Date | 2021-12-12 |