| NPI | 1295057164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 344623) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 261462) |
| 363LF0000X Nurse Practitioner Family (Licence: NY 344623) | |
| Enumeration Date | 2010-02-19 |
| Last Update Date | 2021-02-02 |