| NPI | 1962922575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5015608) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 714603-1) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F342581) | |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2024-06-25 |