| NPI | 1770167538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 356500) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 0727863) |
| Enumeration Date | 2021-05-07 |
| Last Update Date | 2025-06-27 |