| NPI | 1124807706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.025639) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.338567) |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2023-09-25 |