| NPI | 1972894731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: NY 420875) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 304821) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2011-04-28 |