| NPI | 1073874673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F302752-1) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner Community Health (Licence: NY F302752-1) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: NY F302752-1) | |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2012-05-31 |