| NPI | 1669917654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209015375) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71007051A) |
| Enumeration Date | 2016-12-29 |
| Last Update Date | 2021-12-15 |