| NPI | 1033520168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 338687) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 22559567) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2015-01-14 |