| NPI | 1770141822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 344471) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.024510) |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 2827419A) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.0030138) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704380248) | |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2022-09-08 |