| NPI | 1790297331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.018242) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 8123-33) |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2019-10-10 |