| NPI | 1962826024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 9372226) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NY RN 387132-1) |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2016-11-03 |