| NPI | 1174998876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3009573) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209013608) |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2020-10-29 |