| NPI | 1881961118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 342977) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 647497-1) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 342977) | |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2020-03-19 |