| NPI | 1154667731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 659854) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 340335) |
| Enumeration Date | 2012-12-31 |
| Last Update Date | 2016-02-04 |