| NPI | 1063860138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 30 307236) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 22 618371) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2016-05-31 |