| NPI | 1225394422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY f3369-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY f3369-1) |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2012-04-02 |