| NPI | 1215415294 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 280363) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 343211) | 
| Enumeration Date | 2018-08-01 | 
| Last Update Date | 2025-10-15 |