| NPI | 1356855878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-016854) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.016854) |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2018-01-04 |