| NPI | 1225635527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019014016) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209018695) |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2020-10-08 |