| NPI | 1902112899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 634562) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F310321-01) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F310321) | |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2023-06-15 |