| NPI | 1306322300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP145170) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209018007) |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2022-07-19 |