| NPI | 1104660703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F356229-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 765301) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11031783) | |
| 163W00000X Registered Nurse (Licence: FL 9507718) | |
| Enumeration Date | 2024-06-20 |
| Last Update Date | 2026-01-14 |