| NPI | 1124513080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209017766) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209017766) |
| Enumeration Date | 2018-06-24 |
| Last Update Date | 2023-03-07 |