| NPI | 1962552588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 339121) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 507084) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2019-07-22 |