| NPI | 1629681796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A167925) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209021811) |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2023-09-26 |