| NPI | 1508452764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: IL 209.022322) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 209.022322) |
| Enumeration Date | 2020-12-11 |
| Last Update Date | 2023-11-27 |