| NPI | 1265670400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F335290) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 522814) |
| 363L00000X Nurse Practitioner (Licence: NY F335290) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F335290) | |
| Enumeration Date | 2009-01-27 |
| Last Update Date | 2010-11-11 |