| NPI | 1295254993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 277.001521) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.016377) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 783133) | |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2021-10-21 |