| NPI | 1750689279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 305598) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 535468) |
| Enumeration Date | 2011-03-08 |
| Last Update Date | 2015-08-20 |