| NPI | 1861965543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 1133284) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209018494) |
| 363LF0000X Nurse Practitioner Family (Licence: IL 209018494) | |
| Enumeration Date | 2019-01-06 |
| Last Update Date | 2024-01-11 |