NPI | 1124784087 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F349194-01) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.023955) |
363LF0000X Nurse Practitioner, Family (Licence: NJ 26NR25717100) | |
Enumeration Date | 2021-11-15 |
Last Update Date | 2025-01-22 |