| NPI | 1861837239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9383284) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209010306) |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2026-08-24 |