| NPI | 1245574391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 343212) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 652680) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2018-07-16 |