| NPI | 1659863462 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NY 431371) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 632529) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2024-04-30 |