| NPI | 1255768719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F341994) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 675138) |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2019-08-27 |