| NPI | 1912561960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11016145) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209019133) |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2022-11-28 |