| NPI | 1902093503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F336520-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 3919561) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2011-05-03 |