| NPI | 1588897805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11002004) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 305025) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 305025) | |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2022-08-01 |