| NPI | 1558788356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 306849) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 609942) |
| 163W00000X Registered Nurse (Licence: NJ 26NR14692700) | |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2014-04-05 |