| NPI | 1790023471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 343478) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 661885) |
| Enumeration Date | 2013-01-30 |
| Last Update Date | 2018-11-16 |