| NPI | 1578128559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 344560) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 739619) |
| Enumeration Date | 2019-05-06 |
| Last Update Date | 2019-07-11 |