| NPI | 1649579145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY F337297-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 483595-1) |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2014-08-29 |