| NPI | 1215202650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F337122-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 504531) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2014-12-17 |