| NPI | 1902063738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F302043-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 396714-1) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2008-05-20 |