| NPI | 1184030512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 339324) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 677188) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 339324) | |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2025-03-18 |