| NPI | 1740619451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 306600) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA 595472) |
| 163W00000X Registered Nurse (Licence: NY 606000) | |
| Enumeration Date | 2013-11-03 |
| Last Update Date | 2017-12-14 |