| NPI | 1124360862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY 306836) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 659467-1) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2018-04-11 |