| NPI | 1568878783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 339355) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 674617) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2015-03-16 |