| NPI | 1770985517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 33 339191) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 22 562311) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2020-02-18 |