| NPI | 1548516867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F336659-1) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 336659) |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2015-10-27 |