| NPI | 1396751145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F332218-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 262025-1) |
| 163W00000X Registered Nurse (Licence: MA 110764) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-08-28 |