| NPI | 1578946661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F-340293-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 22648752) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2016-06-30 |