| NPI | 1588138416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11019496) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209017880) |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2023-11-30 |