| NPI | 1871996330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F338145-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 8244145) |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2014-12-17 |