| NPI | 1164106167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 351620) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 2022068630) |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2023-09-07 |