| NPI | 1316298110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 343890) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 659759) |
| Enumeration Date | 2012-09-20 |
| Last Update Date | 2021-03-18 |