| NPI | 1912419185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY F308263-1) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F308263-1) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NY F308263-1) | |
| Enumeration Date | 2017-10-28 |
| Last Update Date | 2022-09-16 |