| NPI | 1992258248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 779840) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NY 008508) |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2025-08-25 |