| NPI | 1548666993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F306095-1) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CT 006063) |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2019-09-24 |