| NPI | 1760758577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F342506-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 641075) |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2022-12-29 |