| NPI | 1790335008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2019026967) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209019957) |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2023-01-18 |