| NPI | 1235711847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 310751) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY xxxxxxxx) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NY xxxx) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN290073) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN290073) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NY xxxxxx) | |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2023-06-21 |