| NPI | 1407680309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 355809) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 784307) |
| Enumeration Date | 2024-09-02 |
| Last Update Date | 2025-05-02 |