| NPI | 1508236464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 19036) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.011706) |
| Enumeration Date | 2015-10-04 |
| Last Update Date | 2020-06-10 |