| NPI | 1215779541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F354361-01) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY F354361-01) |
| 363L00000X Nurse Practitioner (Licence: NY F354361-01) | |
| Enumeration Date | 2024-06-07 |
| Last Update Date | 2025-05-09 |