| NPI | 1174760656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 594585-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F335802) |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2021-04-20 |