| NPI | 1205225158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 693212) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: NY 693212) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2020-04-24 |