| NPI | 1609872548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F331907-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 5223686) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2010-01-08 |