| NPI | 1063039378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024178357) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.022272) |
| 363L00000X Nurse Practitioner (Licence: MO 2021029431) | |
| Enumeration Date | 2020-07-02 |
| Last Update Date | 2022-12-30 |