| NPI | 1700152584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 337986) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 462795-1) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2015-12-10 |