| NPI | 1164670303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F334488-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 400461-1) |
| Enumeration Date | 2008-08-29 |
| Last Update Date | 2020-01-09 |