| NPI | 1972630424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 200600882622) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209007316) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2021-03-01 |