| NPI | 1245717115 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024190662)  | 
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 343829)  | 
| 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 9251690)  | |
| Enumeration Date | 2018-07-24 | 
| Last Update Date | 2025-07-08 |