| NPI | 1003478066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2019024744) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209019574) |
| Enumeration Date | 2019-06-30 |
| Last Update Date | 2021-05-25 |