| NPI | 1194909564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F343850) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 1014962) |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2019-09-16 |