| NPI | 1215537790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5020622) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209020941) |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2024-08-13 |