| NPI | 1558611814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 306650) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2277737) |
| 163W00000X Registered Nurse (Licence: NY 672244) | |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2014-04-02 |