| NPI | 1003165374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F303920) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 303920) |
| Enumeration Date | 2012-09-02 |
| Last Update Date | 2015-07-30 |