| NPI | 1760420681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F303016) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 484615) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2008-03-12 |