| NPI | 1578019907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F307860) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 307860) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 537603) | |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2018-08-16 |