| NPI | 1396114609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 9190) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209013210) |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2022-12-07 |