| NPI | 1790931780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F335603-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 534947-1) |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2018-01-04 |