| NPI | 1346675717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F306486-1) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NY 501705) |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2013-09-04 |