| NPI | 1053846162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 341686) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209024842) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: MI 4704380894) | |
| 363LP2300X Nurse Practitioner Primary Care (Licence: OH 0030892) | |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2022-09-08 |