| NPI | 1417103334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 335770) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 003839) |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2012-01-04 |