| NPI | 1659865129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 23884) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2018018089) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209017701) | |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2021-03-04 |