| NPI | 1356670640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 350530) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 299002) |
| Enumeration Date | 2009-12-15 |
| Last Update Date | 2023-01-27 |