| NPI | 1659712370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 338524) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 657972-1) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2015-05-13 |