| NPI | 1649041146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY 311354) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F311354-01) |
| Enumeration Date | 2024-01-12 |
| Last Update Date | 2025-09-04 |