| NPI | 1033520580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 339054) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: TN 18672) |
| Enumeration Date | 2014-05-17 |
| Last Update Date | 2014-07-29 |