| NPI | 1356993372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209.019621) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.019621) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.019621) | |
| Enumeration Date | 2019-07-10 |
| Last Update Date | 2023-10-05 |