| NPI | 1992917819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 5499577) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 5799828) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY f381289) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2007-08-14 |