| NPI | 1124571070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 344801) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 594562-1) |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2020-04-03 |