| NPI | 1992443519 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R269552)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 346165)  | 
| Enumeration Date | 2022-05-24 | 
| Last Update Date | 2024-12-10 |