| NPI | 1144804840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209023365) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041456666) |
| 363L00000X Nurse Practitioner (Licence: IL 209.023365) | |
| Enumeration Date | 2021-05-09 |
| Last Update Date | 2022-06-16 |