| NPI | 1790034759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 341185) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 653476) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2016-12-04 |