| NPI | 1679925820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 341547) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 701599) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2017-07-14 |