| NPI | 1083148787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2017003583) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209015719) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2020-06-22 |