| NPI | 1942611736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F307024-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 569327-1) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2015-01-20 |