| NPI | 1164793832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F337170) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 632129) |
| Enumeration Date | 2012-01-26 |
| Last Update Date | 2012-03-29 |