| NPI | 1053710822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F346417-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 689369) |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2020-09-16 |