| NPI | 1164997870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11003744) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209017948) |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2020-06-08 |