| NPI | 1194261479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA 108072) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209015676) |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2021-02-11 |