| NPI | 1205193273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 320096) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 299946) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2018-03-17 |