| NPI | 1982212965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11013923) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9559018) |
| 163W00000X Registered Nurse (Licence: AL 1-134345) | |
| 207RG0100X Internal Medicine Gastroenterology (Licence: NY 220556) | |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2021-11-11 |