| NPI | 1265774517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F306802) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 657599) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2015-10-14 |