| NPI | 1669884458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 343508) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 654235) |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2018-10-01 |