| NPI | 1073952651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: NY F337239-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY F337239-1) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2016-11-21 |