| NPI | 1649683525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F306429-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 581792-1) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2014-06-09 |