| NPI | 1699053108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 341473) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NM 6458) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2024-12-18 |