| NPI | 1538274451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 303779) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 497423 / 303779) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2017-02-16 |