| NPI | 1518192566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 305009) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 577406) |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2014-12-17 |