| NPI | 1306329594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2020011023) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.018114) |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2022-01-24 |