| NPI | 1083616486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY F333906) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 530570-1) |
| 163W00000X Registered Nurse (Licence: NJ 26NO12294700) | |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2007-07-09 |