| NPI | 1639988207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL F11240542) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F356564) |
| Enumeration Date | 2025-01-07 |
| Last Update Date | 2025-12-23 |