| NPI | 1205301272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 817972) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 4043029) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP139110) | |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2025-07-11 |