| NPI | 1033599576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11045515) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 339662) |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2026-02-25 |