| NPI | 1417496696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 308604) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 717948) |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2019-01-17 |