| NPI | 1730799164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 346281) |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2025-03-04 |