| NPI | 1619272739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F338620-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 616783) |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2014-03-21 |