| NPI | 1265989149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3013671) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209-014339) |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2020-09-16 |