| NPI | 1902067135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 306191) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 597310) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2013-07-25 |