| NPI | 1962977223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 7825) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209020757) |
| Enumeration Date | 2018-10-12 |
| Last Update Date | 2020-05-15 |