| NPI | 1790182103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209011329) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 14974-33) |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2024-07-18 |