| NPI | 1912313602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY F338930) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 546767) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2019-01-21 |