| NPI | 1205563400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 348677) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F348677-01) |
| Enumeration Date | 2022-08-07 |
| Last Update Date | 2025-10-29 |