| NPI | 1114376944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 33341554) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 701657-1) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2017-02-23 |