| NPI | 1164795092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F343538-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 638084-1) |
| Enumeration Date | 2012-02-23 |
| Last Update Date | 2019-10-28 |