| NPI | 1871850719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 350365) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 607674) |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2022-11-29 |