| NPI | 1720366305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F303344-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 435241-1) |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2011-07-29 |