| NPI | 1265613442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 310449) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 281638) |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2021-12-22 |