| NPI | 1487171740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11005466) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 633467) |
| 363L00000X Nurse Practitioner (Licence: NY 344795) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11005466) | |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2021-11-15 |