| NPI | 1316931538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9177378) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 002392) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 9177378) | |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2019-04-25 |