| NPI | 1619099553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F334450) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F-303545) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2009-05-27 |