| NPI | 1629305602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 302749) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 302749) |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2021-02-19 |