| NPI | 1578729869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F302364) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 30-302364) |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2016-10-25 |