| NPI | 1740714724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016031428) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209015440) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2021-05-10 |