| NPI | 1760949655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY 2018023443) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NY 308921) |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2020-05-05 |