| NPI | 1922604172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 1232650) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 346938) |
| Enumeration Date | 2020-12-11 |
| Last Update Date | 2026-03-16 |