| NPI | 1659928398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5017966) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5017966) |
| 363L00000X Nurse Practitioner (Licence: IL 209020066) | |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2023-04-14 |