| NPI | 1912241886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY f347436-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 654160) |
| Enumeration Date | 2012-11-16 |
| Last Update Date | 2021-10-08 |