| NPI | 1649912965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 1304557-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041423630) |
| Enumeration Date | 2022-04-07 |
| Last Update Date | 2023-02-09 |