| NPI | 1972842169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 342367) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 663234) |
| Enumeration Date | 2013-02-07 |
| Last Update Date | 2020-07-17 |