| NPI | 1174506158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F303346-1) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 002595) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2023-03-07 |