| NPI | 1477948636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 349510) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1000576) |
| 363L00000X Nurse Practitioner (Licence: IL 209012692) | |
| 363L00000X Nurse Practitioner (Licence: IL 277003811) | |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2026-03-25 |