| NPI | 1073862207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F339329) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 652493) |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2021-03-16 |