| NPI | 1861842585 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F341675-1) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 22 694439) | 
| Enumeration Date | 2016-06-14 | 
| Last Update Date | 2018-11-06 |