| NPI | 1215096482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F3403661) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F3041711) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2011-01-06 |