| NPI | 1093065930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: IL 041318535) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: HI 72584) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11009284) | |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2021-07-16 |