| NPI | 1992946008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 343738) |
| Additional Taxonomies | 261Q00000X |
| 163W00000X Registered Nurse (Licence: NY 606055) | |
| Enumeration Date | 2009-03-19 |
| Last Update Date | 2022-11-01 |