NPI | 1851357503 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 332329) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704378539) |
363LF0000X Nurse Practitioner, Family (Licence: IN 71012557A) | |
363LF0000X Nurse Practitioner, Family (Licence: IL 209.023953) | |
363LF0000X Nurse Practitioner, Family (Licence: OH 0029700) | |
363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F380527-1) | |
Enumeration Date | 2006-04-21 |
Last Update Date | 2022-09-08 |