| NPI | 1306207139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209013993) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209013993) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209013993) | |
| Enumeration Date | 2016-03-07 |
| Last Update Date | 2022-01-06 |