| NPI | 1376804617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 355416) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 785113) |
| 164W00000X Licensed Practical Nurse (Licence: NY 298551) | |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2025-03-18 |