| NPI | 1992768337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F303793) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 30-303793) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2021-02-19 |