| NPI | 1962004440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 804851) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NY 804851) |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2020-11-10 |