| NPI | 1073093803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.018223) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041366750) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 9527-33) | |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2022-06-06 |