| NPI | 1174985493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016005870) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209014066) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2016-06-17 |