| NPI | 1396140893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F431752-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 677398-1) |
| 363L00000X Nurse Practitioner (Licence: NY F43175201) | |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2020-12-27 |