| NPI | 1104166420 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 306076)  | 
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: NY 605444)  | 
| Enumeration Date | 2013-02-22 | 
| Last Update Date | 2023-10-11 |