| NPI | 1932179751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.007890) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 117826) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2021-12-06 |