| NPI | 1790463412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F311353-01) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F311353-01) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NY F311353-01) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NY F311353-01) | |
| Enumeration Date | 2023-07-11 |
| Last Update Date | 2023-07-17 |