| NPI | 1386622694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F334257) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 334257) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 005771) | |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2021-11-29 |