| NPI | 1881236248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2018036141) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 209020142) |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2020-11-26 |