| NPI | 1194720649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A062587) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209003631) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2022-01-21 |