| NPI | 1649622622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015043224) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209014333) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2015043224) | |
| Enumeration Date | 2016-07-01 |
| Last Update Date | 2020-04-07 |