| NPI | 1295066405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 309889) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 297914-1) |
| 163W00000X Registered Nurse (Licence: NY 661674) | |
| Enumeration Date | 2010-01-28 |
| Last Update Date | 2021-05-20 |