| NPI | 1952654840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 337456) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 590629) |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2014-02-18 |