| NPI | 1750051090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 26697) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.023784) |
| Enumeration Date | 2021-09-17 |
| Last Update Date | 2024-08-19 |