| NPI | 1366839557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY 307280) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 617794) |
| Enumeration Date | 2015-04-25 |
| Last Update Date | 2015-07-27 |