| NPI | 1992966287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA IA A087090) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.005344) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2024-07-18 |