| NPI | 1629337142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F303084-1) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 329012-1) |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2012-05-04 |