| NPI | 1538324991 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F304882-1)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 407046-1)  | 
| Enumeration Date | 2008-07-25 | 
| Last Update Date | 2012-08-06 |