| NPI | 1366729782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 337043) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 623510) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2013-08-18 |