| NPI | 1043769052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 309859) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 721600-1) |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2020-12-14 |