| NPI | 1699821793 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VI 10977P)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F303582)  | 
| Enumeration Date | 2007-01-25 | 
| Last Update Date | 2016-09-12 |