| NPI | 1821334210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 339525) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 623463) |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2016-06-03 |