| NPI | 1952603441 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5017789) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 346154) | 
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5017789) | |
| 163W00000X Registered Nurse (Licence: NY 633981) | |
| Enumeration Date | 2010-12-03 | 
| Last Update Date | 2025-07-14 |