| NPI | 1770882995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F336556-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 565845-1) |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2011-03-28 |