| NPI | 1891381604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 307970) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NY 307970) |
| Enumeration Date | 2020-12-15 |
| Last Update Date | 2020-12-15 |