| NPI | 1205570074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 349505) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71013825A) |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2025-07-08 |