| NPI | 1164935789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 15910-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.016691) |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2024-12-09 |