| NPI | 1821479908 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209023916) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71005553a) | 
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209023916) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71005553A) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IN 28208703A) | |
| Enumeration Date | 2015-06-15 | 
| Last Update Date | 2025-04-18 |