| NPI | 1104908789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F342776-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 565344-1) |
| 171100000X Acupuncturist (Licence: NY 2030) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2018-04-02 |