| NPI | 1114267168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 343759) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 661836) |
| Enumeration Date | 2013-02-27 |
| Last Update Date | 2019-01-14 |