| NPI | 1174474589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F360364-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 801899) |
| Enumeration Date | 2026-02-04 |
| Last Update Date | 2026-07-08 |