| NPI | 1518234640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 338514) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 645101) |
| Enumeration Date | 2011-11-17 |
| Last Update Date | 2021-03-10 |