| NPI | 1811990856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F331378) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F300834) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2007-10-25 |