| NPI | 1053414250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 330819) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 452777) |
| 207N00000X Dermatology (Licence: NY 330819) | |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2018-02-01 |