| NPI | 1538223391 |
|---|---|
| Former Name | NONE NONE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F334877-1) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F334877) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-02-04 |