| NPI | 1649706219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F342645-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR19090800) |
| 163W00000X Registered Nurse (Licence: NY 717945) | |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2019-12-09 |