| NPI | 1013165943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 383082) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 18461) |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2020-02-11 |