| NPI | 1639396906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 211071) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F330509) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2007-07-08 |