| NPI | 1023433745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014004544) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.014868) |
| Enumeration Date | 2014-03-04 |
| Last Update Date | 2016-10-17 |