| NPI | 1750763645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY F338147-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 589013-1) |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2017-04-20 |