| NPI | 1780113597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 402211) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 566059) |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2017-07-19 |