| NPI | 1124596796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11000152) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209018443) |
| Enumeration Date | 2018-11-12 |
| Last Update Date | 2023-04-05 |