| NPI | 1790318525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95029510) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209025207) |
| 363LF0000X Nurse Practitioner, Family (Licence: OH 026359) | |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2024-12-14 |