| NPI | 1114039401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 334675) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 507811) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2011-11-14 |