| NPI | 1063148039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 349818) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 671638) |
| Enumeration Date | 2022-08-01 |
| Last Update Date | 2025-07-09 |