| NPI | 1003119991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 353878) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 294214) |
| Enumeration Date | 2010-12-15 |
| Last Update Date | 2024-07-27 |