| NPI | 1992290787 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11008255) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 343012) | 
| Enumeration Date | 2018-06-25 | 
| Last Update Date | 2025-04-04 |