| NPI | 1649755190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F347658) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM RN-89507) |
| 163W00000X Registered Nurse (Licence: AZ 217929) | |
| 163W00000X Registered Nurse (Licence: NY 790555) | |
| 163WG0000X Registered Nurse, General Practice (Licence: TN 225421) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ 217929) | |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2021-07-02 |