| NPI | 1376031625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209018254) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 041.318860) |
| 163W00000X Registered Nurse (Licence: IL 041.318860) | |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2021-06-30 |