| NPI | 1154212504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL 9511901) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 504028) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11040844) | |
| Enumeration Date | 2025-07-14 |
| Last Update Date | 2025-07-14 |