| NPI | 1174922041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 1837552) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 430806) |
| Enumeration Date | 2014-08-17 |
| Last Update Date | 2015-06-10 |