| NPI | 1407265556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 338947) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 338947) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: NY 338947) | |
| Enumeration Date | 2014-08-02 |
| Last Update Date | 2014-08-02 |