| NPI | 1063105997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 351919) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 351919) |
| Enumeration Date | 2023-05-26 |
| Last Update Date | 2025-11-03 |