| NPI | 1639587082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 307009) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 559461) |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2018-02-14 |