| NPI | 1104459270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R181863) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1227411) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL TPAN4279) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.034748) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NH 116686-23) | |
| 363LF0000X Nurse Practitioner, Family (Licence: UT 14272676-4405) | |
| 163W00000X Registered Nurse (Licence: MD R191963) | |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP035021) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ15493100) | |
| Enumeration Date | 2020-02-18 |
| Last Update Date | 2026-03-11 |