| NPI | 1306300421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209018665) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.367062) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.018665) | |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2024-06-03 |