| NPI | 1659627495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F305796-1) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 305796) |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2014-10-15 |