| NPI | 1821079740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F340474) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F303297) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2018-11-20 |