| NPI | 1962932533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 3426211) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 722617) |
| 163W00000X Registered Nurse (Licence: NY 7226171) | |
| 163W00000X Registered Nurse (Licence: NY 722617-1) | |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2018-07-30 |