| NPI | 1316175367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 335947) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 430625) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 33 335947) | |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2022-02-10 |