| NPI | 1316449200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-78722-122) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209017010) |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2019-09-22 |