| NPI | 1245800069 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 309965)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 759013-1)  | 
| Enumeration Date | 2021-06-25 | 
| Last Update Date | 2021-06-25 |