| NPI | 1104462738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.021965) |
| Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: IL 041434377) |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2020-09-16 |