| NPI | 1912218512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 338375) |
| Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: NY 5487671) |
| 163W00000X Registered Nurse (Licence: NY 548767-1) | |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2013-12-11 |