| NPI | 1154375459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F330692) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 163926) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2009-11-19 |