| NPI | 1942954169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.024736) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 2029.024736) |
| Enumeration Date | 2022-02-07 |
| Last Update Date | 2024-10-03 |