| NPI | 1609362532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 675097) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NY 308600) |
| Enumeration Date | 2018-07-03 |
| Last Update Date | 2018-07-03 |