| NPI | 1063722619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F345755) |
| Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: NY 577426) |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2020-09-04 |