| NPI | 1689161614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1014361) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209017454) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2021-06-18 |