| NPI | 1700304508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2009010907) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 0414370057) |
| Enumeration Date | 2017-09-01 |
| Last Update Date | 2022-07-21 |