| NPI | 1164839056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F339464-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 677784) |
| 163W00000X Registered Nurse (Licence: CA 95028557) | |
| Enumeration Date | 2014-07-13 |
| Last Update Date | 2015-04-18 |