| NPI | 1790374973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.026544) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209026544) |
| Enumeration Date | 2021-01-13 |
| Last Update Date | 2023-08-30 |