| NPI | 1568760627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F342803) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 627007) |
| Enumeration Date | 2011-03-14 |
| Last Update Date | 2018-10-29 |