| NPI | 1124503313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61084001) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 209016620) |
| 363L00000X Nurse Practitioner (Licence: IL 209016620) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209016620) | |
| Enumeration Date | 2018-10-03 |
| Last Update Date | 2023-01-11 |