| NPI | 1609207596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 340996) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 659463) |
| Enumeration Date | 2013-12-03 |
| Last Update Date | 2016-08-10 |