| NPI | 1093235319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F342636-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 718612) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2018-04-10 |