| NPI | 1962175992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F348937-01) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11012574) |
| Enumeration Date | 2021-07-27 |
| Last Update Date | 2025-03-28 |