| NPI | 1417224817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 309405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 652645) |
| Enumeration Date | 2011-11-29 |
| Last Update Date | 2020-04-16 |