| NPI | 1578257069 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 352037)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5019189)  | 
| Enumeration Date | 2023-06-07 | 
| Last Update Date | 2025-09-03 |