| NPI | 1194109165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F307224) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 599788) |
| Enumeration Date | 2015-07-19 |
| Last Update Date | 2019-10-11 |