| NPI | 1962546812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 516958) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY 333774) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2007-07-08 |