| NPI | 1962918417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 308588) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 561419) |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2021-03-03 |