| NPI | 1578990032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209015367) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: IL 209.015367) |
| 286500000X Military Hospital | |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2025-06-06 |