| NPI | 1871809962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 339241) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 592511) |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2014-12-15 |