| NPI | 1073822771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 305564) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 305564) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: NY 421000) | |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2011-12-28 |