| NPI | 1609395052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1016912) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209016034) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2025-03-10 |