| NPI | 1902187909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 6421131) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F342570-1) |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2019-07-09 |