| NPI | 1457470494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 4023-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 332571) |
| 363L00000X Nurse Practitioner (Licence: NY F303304) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2010-09-01 |