| NPI | 1063000719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.020987) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2020011108) |
| Enumeration Date | 2021-01-07 |
| Last Update Date | 2024-05-08 |