| NPI | 1396356010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 9506413) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.021439) |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2021-04-14 |