| NPI | 1407198658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 659608-1) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95000758) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2015-04-23 |