| NPI | 1053665851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 351029) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 311347) |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2022-12-30 |