| NPI | 1740804046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 295976) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.021353) |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2023-11-02 |