| NPI | 1124611983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209022673) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001242135) |
| 163W00000X Registered Nurse (Licence: IN 041437155) | |
| 163W00000X Registered Nurse (Licence: WI 224704) | |
| Enumeration Date | 2021-02-12 |
| Last Update Date | 2021-02-12 |