| NPI | 1144627993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F403116) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 693637) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 403116-1) | |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2021-07-27 |