| NPI | 1740628510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F306442) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 600-769-1) |
| 163W00000X Registered Nurse (Licence: NJ 26NR13978000) | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2020-01-10 |