| NPI | 1790187789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 360510) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 274803-1) |
| 163W00000X Registered Nurse (Licence: NY 757133) | |
| Enumeration Date | 2014-09-22 |
| Last Update Date | 2026-07-27 |