| NPI | 1205627296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 356860) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 752942) |
| Enumeration Date | 2025-05-16 |
| Last Update Date | 2026-05-29 |