| NPI | 1295197523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 310859) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 661348) |
| 163W00000X Registered Nurse (Licence: PA 655384) | |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2022-08-29 |