| NPI | 1487648812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F304044-1) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 320528-1) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2008-10-20 |