| NPI | 1811140684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 306460) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 238787) |
| Enumeration Date | 2008-10-24 |
| Last Update Date | 2018-04-16 |