| NPI | 1295200491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018040549) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.464457) |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2024-09-17 |