| NPI | 1154726511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-012088) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 9652-33) |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2021-08-31 |