| NPI | 1528302049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F346523) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 663820) |
| Enumeration Date | 2012-11-21 |
| Last Update Date | 2021-12-08 |