| NPI | 1215398862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11007579) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209014032) |
| Enumeration Date | 2016-03-10 |
| Last Update Date | 2020-12-14 |