| NPI | 1235853904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.026069) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.526617) |
| Enumeration Date | 2022-09-27 |
| Last Update Date | 2022-09-27 |