| NPI | 1700770963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 30163) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 803404) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 355818) | |
| Enumeration Date | 2025-06-04 |
| Last Update Date | 2025-09-04 |