| NPI | 1720396492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 354785) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 745918) |
| 164W00000X Licensed Practical Nurse (Licence: NY 290682) | |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2024-07-12 |