| NPI | 1689177966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 343167) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 589198) |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2018-06-23 |