| NPI | 1649604265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F430132) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 445533) |
| Enumeration Date | 2013-08-30 |
| Last Update Date | 2013-08-30 |