| NPI | 1699199489 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F307880) |
| Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: NY 7838635) |
| Enumeration Date | 2014-02-13 |
| Last Update Date | 2017-06-22 |