| NPI | 1497107478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 307863) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 646907) |
| Enumeration Date | 2016-07-01 |
| Last Update Date | 2017-02-09 |