| NPI | 1912170861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F304517-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 472064-1) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2008-04-10 |