| NPI | 1598545766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10010099) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F359404-01) |
| Enumeration Date | 2023-10-04 |
| Last Update Date | 2026-04-14 |