| NPI | 1750415766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 334140) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F33041-1) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2017-02-27 |