| NPI | 1679820724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY F355385) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 656828) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2024-10-29 |