| NPI | 1194166249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 338537) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 660348) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2014-04-17 |