| NPI | 1396252029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 342474) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 701802) |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2018-01-16 |