| NPI | 1023549862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017024419) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209017720) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2024-03-19 |