| NPI | 1851179675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023032208) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209028406) |
| Enumeration Date | 2023-09-21 |
| Last Update Date | 2023-12-18 |