| NPI | 1871890673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F302301) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 497791) |
| 163W00000X Registered Nurse (Licence: WI 104000-30) | |
| Enumeration Date | 2011-02-15 |
| Last Update Date | 2011-02-15 |