| NPI | 1922113133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 304276) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY F304276 / 412102) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2019-01-07 |