| NPI | 1235535790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209011248) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 209.011248) |
| Enumeration Date | 2014-11-11 |
| Last Update Date | 2020-12-23 |