| NPI | 1265718563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F334432-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 517493-1) |
| Enumeration Date | 2011-10-31 |
| Last Update Date | 2022-05-18 |