| NPI | 1619121142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 638805-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F354056) |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2025-09-22 |