| NPI | 1497789184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 300443) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NY 231831) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 002769) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2007-07-14 |