| NPI | 1417209768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 12204) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209009902) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 12204-33) | |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2024-09-13 |