| NPI | 1063703684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 305594) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 562785) |
| Enumeration Date | 2011-04-30 |
| Last Update Date | 2012-06-22 |