| NPI | 1669922654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN304192) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041368107) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209014505) | |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2021-09-27 |