| NPI | 1912313602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F338930) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95025689) |
| 163W00000X Registered Nurse (Licence: NY 546767) | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2025-10-30 |