| NPI | 1164573036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 334063) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F1103327) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2015-07-31 |