| NPI | 1922537158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 342543) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 717779) |
| Enumeration Date | 2017-06-10 |
| Last Update Date | 2018-01-30 |