| NPI | 1134593635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 277.000784) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.013407) |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2021-01-29 |