| NPI | 1598311433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.025452) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F34462601) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95015045) | |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2022-09-27 |