| NPI | 1831466655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 337121) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 274431) |
| 363LF0000X Nurse Practitioner Family (Licence: NY 33337121) | |
| Enumeration Date | 2011-11-22 |
| Last Update Date | 2020-01-25 |