| NPI | 1770596652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F300547-1) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 300547) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2023-07-05 |