| NPI | 1114460136 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F311082-01)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 723956-1)  | 
| Enumeration Date | 2016-11-22 | 
| Last Update Date | 2022-11-29 |