| NPI | 1902504863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11029978) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 919425) |
| 163W00000X Registered Nurse (Licence: FL 9597087) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 353237) | |
| Enumeration Date | 2023-02-20 |
| Last Update Date | 2024-02-14 |