| NPI | 1356764740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 30 306548) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 22 616794) |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2014-09-22 |