| NPI | 1699064907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F337789-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 609945) |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2020-10-29 |