| NPI | 1902524093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.025608) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 10471-33) |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2022-09-11 |