| NPI | 1053395152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F300033-1) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: NY F360102-1) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2007-07-09 |