| NPI | 1851943708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.025930) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704317522) |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2022-11-15 |