| NPI | 1275183352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 14205-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019010058) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209019233) | |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2023-09-28 |