| NPI | 1447676002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11003804) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.011296) |
| Enumeration Date | 2014-03-06 |
| Last Update Date | 2021-07-29 |