| NPI | 1588919559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 306056) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA rn271463) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2022-08-19 |