| NPI | 1871926204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 308945) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 308304) |
| 163W00000X Registered Nurse (Licence: NY 686821) | |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2018-11-11 |