| NPI | 1790813624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F303998) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 501858-1) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2016-04-22 |