| NPI | 1609500305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 310806) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 75332201) |
| Enumeration Date | 2022-07-11 |
| Last Update Date | 2022-08-03 |