| NPI | 1477211712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11016750) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11016750) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.024529) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11016750) | |
| Enumeration Date | 2021-12-03 |
| Last Update Date | 2022-08-12 |