| NPI | 1023755089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11027957) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209025195) |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2023-09-23 |