| NPI | 1336214352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F301177) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2007-11-28 |