| NPI | 1013472406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 12772236-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.018880) |
| Enumeration Date | 2019-02-10 |
| Last Update Date | 2022-10-20 |