| NPI | 1083924542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 341429) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 631586) |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2017-02-09 |