| NPI | 1346510492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11002336) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209003729) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209003729) | |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2021-06-09 |