| NPI | 1073003463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-017626) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.017626) |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2024-06-10 |