| NPI | 1144742552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 342648) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 722118-1) |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2020-01-29 |