| NPI | 1457800948 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F340517) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 585885) | 
| Enumeration Date | 2016-09-26 | 
| Last Update Date | 2016-09-26 |