| NPI | 1124593892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F342716-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 674631-1) |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2018-10-09 |