| NPI | 1013261866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 363715) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 647036) |
| 363L00000X Nurse Practitioner (Licence: PA SP023507) | |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2022-10-11 |