| NPI | 1831479864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F343606-1) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 002776-1) |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2019-01-22 |