| NPI | 1497052823 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9407621)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 616703)  | 
| 163W00000X Registered Nurse (Licence: NJ 26NR15163600)  | |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F336576)  | |
| 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00327600)  | |
| Enumeration Date | 2011-02-21 | 
| Last Update Date | 2015-09-03 |