| NPI | 1538688312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.016499) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: IL 209.016499) |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2020-04-08 |