| NPI | 1487046397 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F307592-1)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 691374-1)  | 
| Enumeration Date | 2015-03-02 | 
| Last Update Date | 2016-03-28 |