| NPI | 1649799289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F342362) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 696991) |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2017-10-24 |