| NPI | 1962818104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 339322) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 22 666431) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2016-10-27 |