| NPI | 1255533089 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F301461-1) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ00024600) | 
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 505348) | |
| Enumeration Date | 2007-06-04 | 
| Last Update Date | 2023-01-31 |