| NPI | 1922481159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 340256) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 625161) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A155614) | |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2019-09-04 |