| NPI | 1124222005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 333809) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 473936) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2014-12-02 |