| NPI | 1396865309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 418677) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F333153) |
| Enumeration Date | 2007-03-31 |
| Last Update Date | 2007-07-08 |