| NPI | 1811527120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019031443) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209019962) |
| Enumeration Date | 2020-01-25 |
| Last Update Date | 2022-04-21 |