| NPI | 1558764217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 344337) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 691687) |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2022-10-01 |