| NPI | 1982769329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: NY 420547) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 269759) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2012-12-21 |