| NPI | 1962957167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.014921) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041407915) |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2021-10-21 |