| NPI | 1366714339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 308472) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 393507-1) |
| Enumeration Date | 2012-02-06 |
| Last Update Date | 2020-05-18 |