| NPI | 1699919860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY F307777) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 614041) |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2016-09-01 |