| NPI | 1033624648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1067257) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.016480) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209016480) | |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2022-08-23 |