| NPI | 1215812169 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F312089) |
| Additional Taxonomies | 163WX0200X Registered Nurse, Oncology (Licence: NY 767298) |
| Enumeration Date | 2025-08-09 |
| Last Update Date | 2025-08-09 |