| NPI | 1588741599 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F337709-1)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT R52086)  | 
| Enumeration Date | 2006-11-01 | 
| Last Update Date | 2013-04-08 |