| NPI | 1023621091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11005453) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 360686) |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2026-09-10 |