| NPI | 1639649486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.018484) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL AG06180135) |
| Enumeration Date | 2018-12-04 |
| Last Update Date | 2018-12-04 |