| NPI | 1457600025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 308974) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 600426) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2018-12-10 |