| NPI | 1689064628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: NY 351022-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F330255-1) |
| Enumeration Date | 2015-01-29 |
| Last Update Date | 2015-01-29 |