| NPI | 1134836828 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD AC004748) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TPAN3581) | 
| 363LF0000X Nurse Practitioner, Family (Licence: NY F350847) | |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024187951) | |
| Enumeration Date | 2022-11-01 | 
| Last Update Date | 2025-08-24 |