| NPI | 1295256766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 342791) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 718794) |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2018-10-04 |