| NPI | 1609173368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F343541-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 629680) |
| Enumeration Date | 2011-02-16 |
| Last Update Date | 2021-08-10 |