| NPI | 1548773575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 69796) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY F341979-1) |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2022-01-07 |