| NPI | 1043745250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F308324-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 631165) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2017-08-05 |