| NPI | 1003444837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 11104) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209020865) |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2021-12-02 |