| NPI | 1780068767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F340310) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 686926-1) |
| Enumeration Date | 2015-07-19 |
| Last Update Date | 2019-09-24 |