| NPI | 1164702510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 336907) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F336907) |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2021-02-11 |