| NPI | 1497026124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F-340009-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 524100-1) |
| Enumeration Date | 2012-01-26 |
| Last Update Date | 2018-10-30 |