| NPI | 1780400168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 356274) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 774838) |
| Enumeration Date | 2024-12-02 |
| Last Update Date | 2025-03-03 |