| NPI | 1467879106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 306508) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 450062) |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2014-06-20 |