| NPI | 1629805122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F359819-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 840238) |
| Enumeration Date | 2024-09-18 |
| Last Update Date | 2026-06-22 |