| NPI | 1720646367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1069490) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209019515) |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2023-02-12 |