| NPI | 1750876405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP141377) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.017502) |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2020-12-08 |