| NPI | 1124177647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A074701) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 277000125) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2019-12-16 |