| NPI | 1568764058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 341709-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 625361) |
| Enumeration Date | 2010-12-03 |
| Last Update Date | 2022-07-21 |