| NPI | 1386999712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 337366) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 337366) |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2022-03-16 |