| NPI | 1104080589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 33334742) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 22525884) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2008-07-15 |