| NPI | 1235639055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 342684) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY F342684) |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2019-01-14 |