| NPI | 1851568612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 420873) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NY F420873-1) |
| 163WG0000X Registered Nurse, General Practice (Licence: NY 387113-1) | |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2012-09-17 |