| NPI | 1063761724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-024731) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 139515-030) |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2024-05-14 |