| NPI | 1386193399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F341173) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 718933-1) |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2016-10-31 |