| NPI | 1205461928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 343005) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 552829-1) |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2024-02-02 |