| NPI | 1225162639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F33391-01) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F3339101) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-05-15 |