| NPI | 1639504897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 338089) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 537821) |
| Enumeration Date | 2013-09-06 |
| Last Update Date | 2014-02-11 |