| NPI | 1760731533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 308122) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 646394) |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2017-02-28 |