| NPI | 1639510837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 307973) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NY 640017) |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2021-02-23 |