| NPI | 1447294038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 320030) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA TP00662A) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2017-10-02 |