| NPI | 1003123050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 336472) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382058) |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2010-09-10 |