| NPI | 1225221963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F3031461) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F4500131) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2011-12-05 |