| NPI | 1730389099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F301047-1) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5003963) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5003963) | |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2022-12-19 |