| NPI | 1780206979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 309930) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 702093) |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2022-12-09 |