| NPI | 1881023299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.010841) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10004471A) |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2024-10-14 |