| NPI | 1154936672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.021969) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0997514-NP) |
| 363L00000X Nurse Practitioner (Licence: IL 209021969) | |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2022-07-18 |