| NPI | 1356715304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179220) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209013356) |
| Enumeration Date | 2015-11-13 |
| Last Update Date | 2021-10-20 |