| NPI | 1871023598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 440052) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 22140) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2020-01-08 |