| NPI | 1629195904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 354865) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F381145) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2007-07-08 |