| NPI | 1538689856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 342518) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 717614) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2018-08-29 |