| NPI | 1356685473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F305581) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 30305581) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2020-07-28 |