| NPI | 1184290025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95025539) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 209) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL F06210197) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 1184290025) | |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2023-07-03 |