| NPI | 1508291907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 698308) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NY 025505) |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2015-04-16 |