| NPI | 1114697109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 357121) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 821605) |
| Enumeration Date | 2021-09-20 |
| Last Update Date | 2026-02-06 |