| NPI | 1053680017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 338489) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5005417) |
| Enumeration Date | 2011-12-21 |
| Last Update Date | 2018-11-13 |