| NPI | 1548662844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 14727) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.011665) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2024-10-15 |