| NPI | 1134610140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A157860) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.003054) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2020-05-12 |