| NPI | 1720002637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 824389) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209005731) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2022-03-28 |