| NPI | 1083421663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 355812) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 866333) |
| Enumeration Date | 2024-12-17 |
| Last Update Date | 2025-01-23 |