| NPI | 1174875090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9778) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209-009496) |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2023-03-22 |