| NPI | 1831631795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F340508-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 22 496055) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2019-09-12 |