| NPI | 1619156973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F336415-1) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024167298) |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2010-09-10 |