| NPI | 1013387471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 357771) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 357771) |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2026-06-02 |