| NPI | 1649366626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 333976) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 476742) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2011-06-03 |