| NPI | 1912231812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 337244) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 6004821) |
| Enumeration Date | 2009-09-24 |
| Last Update Date | 2019-05-30 |