| NPI | 1013567734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019022414) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209020305) |
| Enumeration Date | 2019-09-14 |
| Last Update Date | 2021-11-30 |