| NPI | 1700202520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 338609) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 630703) |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2017-08-17 |