| NPI | 1902164379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F346480-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 655370) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2021-01-19 |