| NPI | 1710973672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: NY F4204171) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F4204171) |
| 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: NY F4204171) | |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2009-09-04 |