| NPI | 1861949216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 9414582) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 8999558) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |