| NPI | 1679954317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 442090) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health (Licence: NY 442090) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2015-06-23 |