| NPI | 1912553124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 32559) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 209.019786) |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2023-09-20 |