| NPI | 1205422649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 353246) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11009758) |
| Enumeration Date | 2020-12-20 |
| Last Update Date | 2024-11-05 |