| NPI | 1740750330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 306679) |
| Additional Taxonomies | 163WC1400X Registered Nurse, College Health (Licence: NY 487398-1) |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2018-11-27 |