| NPI | 1619261542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 305684) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 305684) |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2021-05-21 |