| NPI | 1013559749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN315458) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN315458) |
| 163W00000X Registered Nurse (Licence: IL 041471013) | |
| 207Q00000X Family Medicine (Licence: MO 2019059648) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2016024087) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209-020379) | |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2023-02-19 |