| NPI | 1396840971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY F333612-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 180313) |
| 363LF0000X Nurse Practitioner Family (Licence: CT 9766) | |
| 363LF0000X Nurse Practitioner Family (Licence: NY 489-156) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2021-07-13 |