| NPI | 1710916929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F302205-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 424426-1) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2024-02-09 |