| NPI | 1265645865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F346635) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 620739) |
| 174400000X Specialist (Licence: NY 28VA1051478) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2021-01-03 |