| 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) |
| Enumeration Date | 2021-11-15 |
| Last Update Date | 2023-07-11 |