| NPI | 1780252940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CT 10158) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY F347302-01) |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2025-05-07 |