| NPI | 1902057052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9754) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.007242) |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2023-10-20 |