| NPI | 1679064265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F342829-1) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00796200) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95012602) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209021873) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00796200) | |
| 363L00000X Nurse Practitioner (Licence: NY F342829-1) | |
| Enumeration Date | 2018-05-20 |
| Last Update Date | 2025-10-18 |