| NPI | 1023265543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 309.003894) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 277.000199) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2021-09-29 |