| NPI | 1083181598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 308801) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 626345) |
| Enumeration Date | 2018-11-01 |
| Last Update Date | 2018-11-01 |