| NPI | 1558904508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2019024738) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209019906) |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2022-12-06 |