| NPI | 1780122564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F307964-1) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F307964-1) |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2020-12-18 |