| NPI | 1114775152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 11880) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.463098) |
| Enumeration Date | 2024-05-06 |
| Last Update Date | 2024-08-21 |