| NPI | 1568012706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 10663) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209-020083) |
| 163W00000X Registered Nurse (Licence: IL 041408670) | |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2022-01-20 |