| NPI | 1104139005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F336377-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 336377) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2023-07-22 |