| NPI | 1114080975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: NY F360324-1) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F360324-1) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2017-05-10 |