| NPI | 1912448846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 308603) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 717753-1) |
| Enumeration Date | 2017-03-10 |
| Last Update Date | 2018-07-09 |