| NPI | 1679934103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 582907-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 344774) |
| Enumeration Date | 2016-03-10 |
| Last Update Date | 2020-07-27 |