| NPI | 1588170625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 341683) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 659180) |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2018-06-07 |