| NPI | 1366002354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.019601) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 209.019601) |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2020-01-02 |