| NPI | 1194033456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 339746) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 634431) |
| Enumeration Date | 2010-09-21 |
| Last Update Date | 2016-11-30 |