| NPI | 1174995658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 343225) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 343225) |
| 163W00000X Registered Nurse (Licence: NY 685753-1) | |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2025-12-10 |