| NPI | 1003124660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 341154) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 580957) |
| 363LF0000X Nurse Practitioner Family (Licence: NY 341154-01) | |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2022-06-30 |