| NPI | 1639856875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F35012-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 801895) |
| Enumeration Date | 2023-06-29 |
| Last Update Date | 2025-02-17 |