| NPI | 1962914135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.016372) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28175074A) |
| Enumeration Date | 2017-10-27 |
| Last Update Date | 2022-09-13 |