| NPI | 1851525349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 334336) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: 334336) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2009-05-12 |