| NPI | 1225888654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 354208) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 942361) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1247288) | |
| Enumeration Date | 2024-03-26 |
| Last Update Date | 2026-09-03 |