| NPI | 1699190892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 382387) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 382387) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382387) | |
| Enumeration Date | 2014-02-25 |
| Last Update Date | 2014-07-24 |