| NPI | 1376329789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209028130) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.028130) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209028130) | |
| Enumeration Date | 2023-09-01 |
| Last Update Date | 2023-10-11 |