| NPI | 1306312145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 308984) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 626859) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 308984) | |
| Enumeration Date | 2018-10-19 |
| Last Update Date | 2022-09-23 |