| NPI | 1174484901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11043838) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 358528) |
| Enumeration Date | 2025-11-20 |
| Last Update Date | 2026-01-22 |