| NPI | 1902275811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 343218) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209012229) |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2019-01-22 |