| NPI | 1306140538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 14961-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.029377) |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2024-03-09 |