| NPI | 1881350791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 312577) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NJ 86277641) |
| Enumeration Date | 2021-11-15 |
| Last Update Date | 2025-11-20 |