| NPI | 1053635342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 305643) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 605076) |
| Enumeration Date | 2010-03-16 |
| Last Update Date | 2023-07-12 |