| NPI | 1124424221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 338299) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 565420) |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2014-11-17 |