| NPI | 1962761510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 34620233) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 652158) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2022-12-29 |