| NPI | 1861808172 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9316934) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F340631-1) | 
| Enumeration Date | 2014-07-08 | 
| Last Update Date | 2025-10-27 |