| NPI | 1689153199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY F342722) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 511177) |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2018-08-07 |