| NPI | 1265786172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 337458) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 006950) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2018-03-17 |