| NPI | 1043440977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F305003) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 464034) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NY F305003) | |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2012-01-18 |