| NPI | 1205155090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 342244) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 654504) |
| 164W00000X Licensed Practical Nurse (Licence: NY 301109) | |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2022-06-24 |