| NPI | 1760253702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY F353766) |
| Enumeration Date | 2024-01-09 |
| Last Update Date | 2024-10-24 |