| NPI | 1841579315 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 348486) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 627453) | 
| 363L00000X Nurse Practitioner (Licence: NY 348486) | |
| Enumeration Date | 2011-08-15 | 
| Last Update Date | 2025-02-05 |