| NPI | 1104289354 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 355405)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 706097)  | 
| Enumeration Date | 2016-04-04 | 
| Last Update Date | 2025-03-31 |