| NPI | 1104945740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 391321) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F302533) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2007-07-08 |