| NPI | 1619337714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA 293054) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 705992) |
| 164W00000X Licensed Practical Nurse (Licence: NY 297094-1) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 309417) | |
| Enumeration Date | 2016-03-02 |
| Last Update Date | 2021-03-27 |