| NPI | 1558808675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F344066) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 642650) |
| 163W00000X Registered Nurse (Licence: MA 234061) | |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2019-11-17 |