| NPI | 1861163339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11015554) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F359363) |
| Enumeration Date | 2021-09-24 |
| Last Update Date | 2026-08-24 |