| NPI | 1538766902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 357933) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 729291) |
| Enumeration Date | 2020-10-07 |
| Last Update Date | 2025-11-21 |