| NPI | 1407511793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.028152) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN478884) |
| Enumeration Date | 2021-11-02 |
| Last Update Date | 2024-07-22 |