| NPI | 1508272964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.015416) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 671943) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 339358) | |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2021-07-29 |