| NPI | 1861055188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95009152) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.018772) |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2022-03-25 |