| NPI | 1871930792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F340318-1) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: NY 646340) |
| Enumeration Date | 2013-06-01 |
| Last Update Date | 2016-03-11 |