| NPI | 1770588378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F302538) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NC 9600447) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2011-03-11 |