| NPI | 1104165802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11011917) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.009659) |
| Enumeration Date | 2013-01-31 |
| Last Update Date | 2023-06-23 |