| NPI | 1194344234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 7514) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041410487) |
| 163W00000X Registered Nurse (Licence: MN 2481244) | |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2022-02-15 |