| NPI | 1164316915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 615-124-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 615-124-1) |
| Enumeration Date | 2025-06-05 |
| Last Update Date | 2025-08-11 |