| NPI | 1255660205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: NY 421290) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 289395-1) |
| Enumeration Date | 2009-12-21 |
| Last Update Date | 2017-08-21 |