| NPI | 1073631610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F304150) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 457603) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2010-10-08 |