| NPI | 1255484226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 494239-1) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner Community Health (Licence: NY F320034-1) |
| 363LF0000X Nurse Practitioner Family (Licence: VA 0024166427) | |
| 163W00000X Registered Nurse | |
| Enumeration Date | 2007-01-20 |
| Last Update Date | 2007-07-08 |