| NPI | 1164863106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F347477-01) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 294815) |
| Enumeration Date | 2013-07-06 |
| Last Update Date | 2021-12-15 |