| NPI | 1700309200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 340592) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 608284) |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2020-06-21 |