| NPI | 1508836495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 330786-1) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA S002121B) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2018-08-20 |