| NPI | 1679823447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 306208) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 576726) |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2020-08-12 |