| NPI | 1639758923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY 309719) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 558789) |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2021-05-07 |