| NPI | 1467024687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 348881) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 348881) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209023591) | |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2023-07-17 |