| NPI | 1790029858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 1215349) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 664120) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2021-09-13 |