| NPI | 1124047642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 333701) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NY 333701) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2022-06-01 |