| NPI | 1760803365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 338455) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 566692) |
| Enumeration Date | 2013-12-27 |
| Last Update Date | 2014-02-07 |