| NPI | 1073066437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.014655) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.368523) |
| 363L00000X Nurse Practitioner (Licence: IL 209014655) | |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2021-02-17 |