| NPI | 1720549124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.015712) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: HI APRN-2667) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2021-03-11 |