| NPI | 1700193604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F340610) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 600230) |
| 163WP0200X Registered Nurse, Pediatrics (Licence: NY 600230) | |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2016-10-31 |