| NPI | 1003334194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 7953) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.020997) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 7953-33) | |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2024-09-25 |