| NPI | 1174053417 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: NY F431297-1)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 717346-1)  | 
| Enumeration Date | 2017-06-19 | 
| Last Update Date | 2018-10-01 |