| NPI | 1639153877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 2144) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209004508) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 2144) | |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2023-04-25 |