| NPI | 1093834871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 304123-1) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F304123-1) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2014-03-12 |