| NPI | 1003658543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 354830) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 938240-01) |
| Enumeration Date | 2024-06-06 |
| Last Update Date | 2024-10-14 |