| NPI | 1548506660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 665567-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 346006) |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2021-06-23 |