| NPI | 1124601463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018039485) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209021641) |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2021-05-04 |