| NPI | 1063878163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 402316) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 22 669021) |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2024-03-11 |