| NPI | 1205552114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.024404) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: IL 041.433397) |
| Enumeration Date | 2022-10-13 |
| Last Update Date | 2022-10-13 |