| NPI | 1053520221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024178497) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209002162) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2023-03-07 |