| NPI | 1023720455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 349666) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY F349666-01) |
| 163W00000X Registered Nurse (Licence: NY 720750-01) | |
| Enumeration Date | 2022-12-16 |
| Last Update Date | 2026-02-11 |