| NPI | 1093119596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 339330) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 6745351) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 339330) | |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2024-02-06 |