| NPI | 1376109918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209019644) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 441811) |
| Enumeration Date | 2019-05-17 |
| Last Update Date | 2019-08-09 |