| NPI | 1730799651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1031069) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.021442) |
| Enumeration Date | 2020-08-05 |
| Last Update Date | 2021-11-22 |