| NPI | 1396763462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 332204) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 332204-1) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2013-10-25 |