| NPI | 1073744819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 344939) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 655539) |
| 164W00000X Licensed Practical Nurse (Licence: NY 294308) | |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2019-08-14 |