| NPI | 1417370412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 33 338471) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 22 581165) |
| Enumeration Date | 2014-01-27 |
| Last Update Date | 2023-02-06 |