| NPI | 1053041657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 348917) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 0028576) |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2023-05-03 |